PROJECT SUMMARY Children with multiple sclerosis (MS) experience a high rate of cognitive impairment, with studies demonstrating cognitive dysfunction in up to half of children and adolescents affected by MS. Whether cognitive impairment relates to scholastic achievement in pediatric MS is currently not known. Dr. Vargas? K 23 proposal will assess the educational impact of multiple sclerosis in childhood. Dr. Vargas? goal is to become a clinical researcher with expertise in the cognitive, scholastic and functional outcomes of children with multiple sclerosis. Dr. Vargas will define the factors associated with poor academic achievement in children and teenagers with MS. Dr. Vargas?s goal is to assess whether cognitive impairment relates to academic impairment and to define the factors associated with academic and cognitive impairment in children with MS. This study will be the first study to evaluate academic achievement and related factors in children and adolescents with MS. Dr. Vargas will test her hypothesis that 1) children with MS will demonstrate academic deficiencies compared to their healthy peers, 2) there will be discordance between cognitive performance and academic performance in children with MS compared to healthy children, and 3) academic performance in children with MS will be related to psychosocial factors which may be intervened upon including mood, fatigue, sleep and social connectedness. This K23 award will provide Dr. Vargas the support needed to develop expertise in 3 major scientific areas: (1) Understanding the advantages and limitations of pediatric neuropsychological and academic testing; (2) Expertise in outcomes research methodology; (3) Mastery of advanced statistical techniques and their clinical application. Dr. Vargas will utilize her clinical-research training in the K23 to lead a multicenter study in New York City and Philadelphia to define the educational impact of childhood-onset multiple sclerosis. The ultimate goal is to identify modifiable variables related to scholastic achievement in children with MS and to target these variables in a large-scale future interventional trial of academic performance.